INCREASING PHYSICAL ACTIVITY TO AID SMOKING CESSATION

说明(由申请人提供)：吸烟仍然是这个国家发病率和死亡率的头号可预防原因(CDC，1997b；McGinennis&Foeging，1993)。此外，尽管实施了一些有效和成本效益高的戒烟方案，但吸烟的流行率在过去几年中并没有下降(CDC，1999b)。改善戒烟效果的一个有希望的方法是增加试图戒烟的吸烟者的体力活动水平。经常锻炼的吸烟者比久坐不动的吸烟者对自己戒烟的能力更有信心(King等人，1996)。来自随机对照试验的证据表明，在戒烟计划中增加锻炼会增加戒烟率，并有助于减少戒烟后的体重增加(Marcus等人，1999；Ussher等人，2000)。然而，以前的试验完全依赖于高度结构化的、有监督的高强度活动，并受到招募参与者困难和长期坚持锻炼养生法的困扰。此外，这些试验通常长期戒烟率较低，这可能至少部分是由于不包括药物干预(例如尼古丁替代)。如果体育活动要在戒烟中发挥作用，似乎需要更好地适应，以提高其可接受性，并将其纳入最先进的行为/药物戒烟计划。通过这一介绍，我们提出了以下具体目标：(1)招募400名久坐或活动最少的吸烟者，并将他们随机分配到两个治疗组中的一个：要么是经过验证的低成本戒烟计划，要么是同样的戒烟计划和体力活动干预；(2)确定这两种干预措施的相对有效性，并进行12个月的随访。试验的主要终点是戒烟，次要终点包括体力活动水平、体重指数、体脂百分比和腰围。

DESCRIPTION (provided by applicant): Smoking remains the number one preventable cause of morbidity and mortality in this nation (CDC, 1997b; McGinnis & Foege, 1993). Moreover, the prevalence of smoking has not declined in the past few years (CDC, 1999b), despite a number of effective and cost-effective smoking cessation programs. One promising method of improving cessation outcomes is to increase physical activity levels in smokers who are trying to quit. Smokers who engage in regular exercise report more confidence in their ability to quit than sedentary smokers (King et al., 1996). There is evidence from randomized controlled trials that adding exercise to cessation programs increases quit rates and helps to reduce post-cessation weight gain (Marcus et al., 1999; Ussher et al., 2000). Previous trials, however, have relied entirely on highly structured, supervised vigorous intensity activity, and have been plagued by difficulty recruiting participants and poor long-term adherence to exercise regimens. Furthermore, these trials generally have had low long-term quit rates, which likely is due at least partly to not including pharmacological intervention (e.g., nicotine replacement). If physical activity is to have a role in smoking cessation, it appears that it will need to be better adapted to increase its acceptability and be integrated into state-of-the-art, combined behavioral/pharmacological cessation programs. With that introduction, we propose the following specific aims: (1) To recruit a cohort of 400 sedentary or minimally active cigarette smokers and randomize them to one of two treatment arms: either a validated, low cost smoking cessation program, or the same smoking cessation program with a physical activity intervention; and (2) To determine the relative efficacy of these two interventions out to a 12-month follow-up. The primary endpoint of the trial is smoking cessation, and secondary endpoints include physical activity level, body mass index, percent body fat, and waist circumference.